Niva Bupa Health Premia Individual Health Insurance

A comprehensive health insurance plan, ‘Health Premia’ provides the perfect coverage for you and your family according to your needs and lifestyle. So, whether it’s going in for newborn child benefits or emergency medical treatments abroad, Health Premia ensures that you get the best in healthcare. After all, your health deserves nothing less.
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Niva Bupa Health Insurance review

Niva Bupa Health Insurance
Sum Insured
2 lacs - 300 lacs options available
Tenure Options
1 year
Claims Incurred Ratio *
54.00%
Claims Settlement Ratio **
85.96%
List of Network Hospitals
4,500+ hospitals
Number of Policies issued *
696,107
Number of Lives Covered *
54,33,000
Maximum Family Floater Coverage
Self, Spouse + 4 dependent children
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Niva Bupa Niva Bupa Health Premia Individual insurance plan details

Platinum plan
Base Sum Insured 1 Cr / 2 Cr / 3 Cr
Benefits
In Patient Care Covered Upto Sum Insured
Room rent Covered Upto Sum Insured
Pre-Hospitalisation Medical Expenses (90 days) Covered Upto Sum Insured
Post-Hospitalisation Medical Expenses (180 days) Covered Upto Sum Insured
Day Care Treatment Covered Upto Sum Insured
Domiciliary Hospitalisation Covered Upto Sum Insured
Alternative Treatment Covered Upto Sum Insured
Living Organ Donor Transplant Covered Upto Sum Insured
Child Care Benefits (Vaccinations for children up to 12 years including one consultation for nutrition and growth during the visit for vaccination) Covered Upto Sum Insured
Specified Illness Cover (1) (outside the geographical boundaries of India for worldwide excluding USA & Canada) Covered up to Sum Insured
Emergency assistance services (only within India)
- Medical referral
- Emergency medical evacuation (air ambulance)
- Medical repatriation
- Compassionate visit
- Care and/or transportation of minor children
- Return of mortal remains
Covered Upto Sum Insured
New Born Baby (covered uptill the end of Policy Year) (2) Covered Upto Sum Insured
Vaccination of the new born baby Covered until new born baby completes one year, vaccinations as per pre-defined list
Emergency Ambulance Network Hospital: Covered up to Sum Insured Non-network Hospital: Covered up to Rs. 2,000 per event
HIV / AIDS (waiting period of 4 years) Covered up to Rs 50,000
Modern Treatments Covered up to Sum Insured with sub-limit of Rs. 1 Lac on few robotic surgeries
LASER surgery cover (waiting period of 3 years) Covered up to Rs 1,00,000
Mental disorder treatment (waiting period of 3 years) Covered up to Sum Insured (sub-limit of Rs 1,00,000 applicable on few conditions)
Second Medical Opinion Covered worldwide, One opinion per Insured Person per Specified Illness / planned Surgery
Premium Waiver One-time premium waiver if the Policyholder dies or suffers from specified illness
Pharmacy and diagnostic services Available through our empanelled service provider
e-Consultation Unlimited tele / online consultations
International coverage (outside the geographical boundaries of India for worldwide excluding USA & Canada) Condition: Annual multi trip (Max 45 days coverage in a single trip); International Sum Insured: up to Rs. 1 cr per insured person
Emergency Hospitalisation Covered up to International Sum Insured
Emergency Medical Evacuation Covered up to International Sum Insured
Compassionate Visit Covered up to International Sum Insured
Care and/or transportation of Minor Children Covered up to International Sum Insured
Return of Mortal Remains Covered up to International Sum Insured
Medical Referral Covered up to International Sum Insured
Medical Repatriation Covered up to International Sum Insured
OPD Cover Covered up to International Sum Insured with a co-payment of 20%
Loss of Passport Covered up to Rs 20,000
Loss of Checked-in baggage Covered up to Rs 10,000
Trip Cancellation & Interruption Rs 25,000
Trip Delay Rs 10,000
Delay of Checked-in Baggage Rs 5,000
OPD Treatment and Diagnostic Services (3) Covered up to Rs 50,000 per policy
Health Check-up (from Day 1) Annual, tests covered up to worth Rs 10,000 per Insured Person
Maternity Benefit (covered for up to 2 pregnancies or terminations) (2) Covered up to Rs 200,000 (worldwide excluding USA & Canada)
Loyalty Additions Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured
Re-fill Benefit Reinstate up to base Sum insured. Applicable for same & different illness as well
Optional Benefits
Personal Accident Cover (for insured aged 18 years & above on individual basis) 1 Cr
Critical illness cover (for insured 18 years & above on individual basis) 25 lacs / 50 lacs / 1 Cr
Enhanced Loyalty Addition Increase of 20% of expiring Base Sum Insured in a Policy Year; maximum up to 200% of Base Sum Insured
International Coverage Extension (outside the geographical boundaries of India for worldwide excluding USA & Canada) Double Sum Insured for ‘international coverage’ benefit
Hospital Cash (4) Rs 7,500/day
Enhanced Geographical Scope for International Coverage USA & Canada included for Maternity Benefit, Specified Illness and International coverage
Health Coach Personalised health coaching for insured aged 18 years & above for any 90 days per Policy Year
Notes: (1) The symptoms of the Specified Illness first occur or manifest itself during the Policy Period and after completion of the 90 day from the inception of 1st Policy with us.
(2) Subject to a continuous coverage of 24 months of that Insured Person since the inception of the first Policy which offers Maternity benefit with us.
(3) 80% of the untilized amount in a policy year gets carried forward to next year; provided the total amount shall not exceed 2.5 times of the benefit limit.
(4) Hospital Cash - Minimum 48 hrs of continuous hospitalisation required. Maximum coverage offered for 30 days/policy year/insured person. Payment made from day one subject to hospitalisation claim being admissible.

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Tax benefits Tax benefits

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